As pioneers in HRT since 1999, we have watched with interest as the hormone therapy landscape has shifted over the years.
Lately, the rumblings surrounding testosterone replacement for women have reached a thunderous pitch.
We’re hearing a lot about the large population of providers that refuse to prescribe testosterone to women (no matter how much they may be needing it).
Increasingly, we’re also hearing about doctors who are prescribing commercially prepared testosterone gel to women. To be clear, the commercially manufactured testosterone we’re talking about is a gel that has been formulated at a strength that is only appropriate for men, as compared to compounded testosterone that can be formulated at lower strengths for women.
But more than anything else, we’re hearing about providers recommending DHEA (dehydroepiandrosterone) to their female patients in lieu of testosterone. So much so, that we felt the topic warranted some blog content. Hence this article.
What’s the Big Deal About Prescribing Testosterone to Women Anyway?
Again, many providers that prescribe HRT to women will not prescribe testosterone to their patients…at all.
To be clear, this is not because their female patients don’t need testosterone. Most of them likely do. Rather, these providers are generally unwilling to prescribe testosterone to women for one of two reasons:
- Often the reluctance stems from the fact that testosterone is a controlled substance. As such, it cannot be prescribed without a DEA license, routine lab work, and adequate oversight.
In other words, prescribing testosterone requires time, effort, documentation, and special licensing. More often than not, the providers who won’t prescribe testosterone to their female patients either can’t or won’t cover these bases.
- The other reason is that testosterone cannot be properly dispensed to women using a conventional pharmacy. Rather, custom compounding (using a compounding pharmacy) is a necessity if testosterone for women is to be prescribed properly (and safely).
In the absence of compounded medication, the only option doctors have is to prescribe commercially prepared testosterone that is intended for male patients—which means dosing that will not be precise or individualized. Once again, the issue here is time, effort, and expertise…because writing prescriptions that are customized to each patient’s needs requires all three.
DHEA Is Being Used as the Big Testosterone Dodge
Our understanding is that many of the providers described above are prescribing DHEA to their patients (instead of testosterone), claiming that DHEA is a suitable substitution for testosterone. But it absolutely is not.
For sure, DHEA is easier to prescribe than testosterone (because DHEA isn’t a controlled substance). And…DHEA is certainly an important hormone in its own right. But DHEA is not testosterone, nor should it be used in place of testosterone.
The rationale provided by practitioners who prescribe DHEA to women in lieu of testosterone is that if a woman takes DHEA, some of that DHEA will convert to testosterone. But this assertion is misleading at best.
It is true that DHEA is a precursor to testosterone, and that DHEA has the potential for converting to testosterone. But…DHEA’s conversion to testosterone is not guaranteed, nor is it consistent. It’s also worth noting that as women age, the degree to which DHEA converts to testosterone decreases.
It is our experience that while some DHEA in a woman’s body might convert to testosterone, that amount will almost never be enough to optimize her levels and positively impact how she feels (if it converts at all).
Certainly, if a woman is DHEA deficient, it will usually make sense for her to supplement DHEA for the benefits that DHEA provides. But the only way to effectively increase testosterone levels in a woman’s body is via testosterone replacement.
The Bottom Line for Women with Low Testosterone
DHEA is not an effective substitute for testosterone replacement. Period. Full Stop. End of story.
At Renew Youth we have been providing physician-supervised HRT (including testosterone replacement for women) since 1999. To start your journey to a healthier you, call us at 800-859-7511 or use our easy contact form to schedule your complimentary 30-minute consultation.